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儿科手术中连续性父母咨询的十年分析:心理社会和医学法律结果。

Ten Years Analysis of Parental Counselling-in-Continuum in Paediatric Surgery: Psychosocial and Medico-legal Outcome.

机构信息

Department of Paediatric Surgery, Command Hospital (Western Command), Chandi Mandir, Haryana, India.

Department of Surgery, Military Hospital, Shimla, Himachal Pradesh, India.

出版信息

Afr J Paediatr Surg. 2024 Apr 1;21(2):90-96. doi: 10.4103/ajps.ajps_110_22. Epub 2023 Mar 31.

Abstract

BACKGROUND

Parents are anxious and apprehensive about the health of their children. A standardised, reproducible and meticulous parental counselling is helpful to both the parents and the treating doctors, as well as markedly reduces instances of scrimmage and medico-legal litigations. The aim of this study is to assess the psychosocial and medico-legal outcomes of parental counselling-in-continuum (PCiC) in paediatric surgery.

MATERIALS AND METHODS

The study was conducted at two government-run Tertiary Healthcare Centres in North India. The study design involves prospective feedback-based study. It included all the admitted paediatric surgery patients. Periodic multisession PCiC was done for each patient by three paediatric surgery teams from 2011 to 2021. At the time of discharge, feedback was taken to assess the psychosocial outcome of PCiC, and the medico-legal outcome was calculated based on the number of litigations.

RESULTS

A total of 22,353 admissions were done in paediatric wards at these institutes. 1574 cases were managed conservatively and 20,779 patients who underwent surgeries were included in the study. 4758 (22.89%) were emergency procedures and 16,021 (77.11%) were elective procedures. Parents rated the counselling efforts excellent in 18,285 (81.80%), good in 3162 (14.14%), satisfactory in 876 (3.91%) and poor in 30 (0.13%) cases with zero medico-legal litigations and 12 incidents of scrimmage.

CONCLUSIONS

PCiC, being a novel concept, should form a centerpiece of paediatric surgical management as it maximally enhances the patient satisfaction level and protects the treating paediatric surgical team from scrimmage and medico-legal litigations.

摘要

背景

父母对孩子的健康感到焦虑和担忧。标准化、可重复和细致的家长咨询对家长和治疗医生都有帮助,并且显著减少了争吵和医疗法律纠纷的发生。本研究旨在评估儿科手术中连续家长咨询(PCiC)的心理社会和医疗法律结果。

材料和方法

该研究在印度北部的两家政府运营的三级保健中心进行。研究设计包括前瞻性基于反馈的研究。它包括所有入院的儿科手术患者。从 2011 年到 2021 年,三个儿科手术团队为每个患者进行定期多轮 PCiC。在出院时,我们会征求家长的意见,以评估 PCiC 的心理社会结果,并根据诉讼数量计算医疗法律结果。

结果

这两个机构的儿科病房共收治了 22353 例患者。1574 例患者接受保守治疗,20779 例接受手术的患者纳入本研究。4758 例(22.89%)为急诊手术,16021 例(77.11%)为择期手术。家长对咨询工作的评价为优秀的有 18285 例(81.80%),良好的有 3162 例(14.14%),满意的有 876 例(3.91%),较差的有 30 例(0.13%),没有医疗法律诉讼,只有 12 起争吵事件。

结论

PCiC 作为一个新概念,应该成为儿科手术管理的核心,因为它最大限度地提高了患者满意度,并保护了治疗儿科手术团队免受争吵和医疗法律纠纷的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d675/11003569/194ff02b3513/AJPS-21-90-g001.jpg

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